STATE PRIORITIES

To help achieve our state policy goals, the Alzheimer’s Association educates legislators and regulators about our issues, offers model legislation for consideration, provides technical assistance for policy makers, brings our advocates to the state houses to tell their personal stories and a wide variety of other programs.

State policy is vital to the work that the Association is doing to meet the needs of individuals living with Alzheimer’s and their families. State officials determine regulatory and statutory standards for dementia training, control spending on state respite care dollars (which affects access to those services), designate spending for state long-term care services, and control Medicaid spending, and in some cases, eligibility and scope of benefits - all of which can have a direct effect on families impacted by Alzheimer's disease.

Since 2007, nearly every state has developed a State Alzheimer's Disease Plan to address to growing economic and social impact of the disease. These comprehensive plans identify critical issues, recommend solutions, and create a roadmap to guide a state's development into a dementia-capable state. State legislatures and state agnecies must fully implement the recommendations included in their state's Alzheimer's disease plan and revisit and re-publish their plans every three to five years to ensure they are kept up to date and account for current needs and recent developments.

People with Alzheimer’s deserve quality care throughout the course of the disease — and they deserve to receive it from knowledgeable professionals across the care continuum. All individuals employed to provide care in residential, home, and adult day settings must be properly trained in dementia care. Yet training standards vary widely by state. For example, less than half of all states require dementia training for staff of nursing homes, and less than one-fifth of states require it for adult day staff. As the number of people living with Alzheimer’s and other dementias increases, states must have adequate dementia- training laws to equip workers across the care continuum with the ability to provide person and family-centered care, communicate effectively with persons with dementia, and address specific and unique aspects of care and safety for people with dementia.

Fewer than half of all people who have been diagnosed with Alzheimer’s disease, or their caregivers, are aware of the diagnosis. Early detection and diagnosis — and knowing of the diagnosis — are essential to ensuring the best medical care and outcomes for those affected by the disease. Healthy People 2020 has set the goal of increasing the percentage of individuals with the disease or their caregivers who are aware of the diagnosis.

There is a growing scientific consensus that regular physical activity, management of certain cardiovascular risk factors (such as diabetes, smoking, and hypertension) and avoidance of traumatic brain injury can reduce the risk of cognitive decline. Studies show these factors may also reduce the risk of dementia. Especially in the absence of a disease-modifying treatment, public health action must be taken to increase public awareness and education about known and potentially modifiable risk factors of cognitive decline and dementia.

Among individuals with Alzheimer’s, 75 percent will be admitted to a nursing home by the age of 80. As a result, Medicaid is critical for many people with Alzheimer’s. While Medicaid spending constitutes one of the largest items in most state budgets — and most states continue to face severe fiscal constraints — state policymakers must ensure that critical benefits are preserved.

Total Medicaid Costs for Americans Age 65 and Older Living with Alzheimer's or Other Dementias by State

State

2018 (in millions of dollars)

2025 (in millions of dollars)

Percentage Increase

Alaska

66

109

63.9%

Alabama

839

1107

31.9%

Arkansas

353

446

26.3%

Arizona

364

537

47.6%

California

3.776

5150

36.4%

Colorado

573

775

35.3%

Connecticut

926

1166

25.9%

District of Columbia

121

132

9.6%

Delaware

226

307

35.8%

Florida

2.502

3392

35.6%

Georgia

1.114

1565

40.4%

Hawaii

207

280

35.4%

Iowa

630

778

23.7%

Idaho

139

193

39.0%

Illinois

1.649

2182

31.1%

Indiana

981

1211

23.4%

Kansas

424

533

25.8%

Kentucky

721

932

29.3%

Louisiana

712

917

28.8%

Massachusetts

1.633

1996

22.2%

Maryland

1.096

1508

37.5%

Maine

197

269

36.9%

Michigan

1.368

1707

24.8%

Minnesota

824

1069

29.7%

Missouri

888

1117

25.8%

Mississippi

564

716

26.9%

Montana

150

199

33.4%

North Carolina

1.188

1600

34.7%

North Dakota

175

211

21.0%

Nebraska

347

404

16.3%

New Hampshire

236

329

39.2%

New Jersey

2.011

2568

27.7%

New Mexico

199

274

37.7%

Nevada

178

272

53.5%

New York

4.834

6206

28.4%

Ohio

2.360

2888

22.4%

Oklahoma

481

600

24.8%

Oregon

235

311

32.7%

Pennsylvania

3.404

3958

16.3%

Rhode Island

438

555

26.6%

South Carolina

573

804

40.2%

South Dakota

167

208

24.3%

Tennessee

989

1353

36.8%

Texas

2.805

3882

38.4%

Utah

160

231

44.9%

Virginia

900

1244

38.2%

Vermont

106

144

36.1%

Washington

497

678

36.4%

Wisconsin

723

909

25.7%

West Virginia

414

512

23.6%

Wyoming

76

109

42.7%

All cost figures are reported in 2018 dollars. State totals may not add to the U.S. total due to rounding. Excerpted from the Alzheimer’s Association’s 2018 Alzheimer’s Disease Facts and Figures report. See the full report for methodology (alz.org/facts).